Niemczyk Stanisław, Matuszkiewicz-Rowńska Joanna, Szamotulska Katarzyna, Sitkowska-Kurzec Zofia, Gomółka Małgorzata, Stopiński Marek, Grochowski Janusz, Niemczyk Longin, Ostrowski Grzegorz, Kulicki Paweł
Oddział Chorób Wewnetrznych ze Stacja Dializ SZP ZOZ Wołomin.
Pol Arch Med Wewn. 2006 Dec;116(6):1144-9.
Evaluation of metoclopramide (MTC) test values in end-stage renal disease patients undergoing hemodialysis with different level of hyperprolactinemia was aim of the study. Clinical value of application of the MTC test and influence of different laboratory and clinical factors including erytropoietin treatment were examined. Sixty-eight hemodialysed patients (31 male and 37 female) aged 20-74 yr. (medium 48 +/- 13 yr.) underwent the MTC test, the control group consisted of 8 healthy volunteers (4 male and 4 female). 10mg of MTC was given i.v. and serum level of PRL was determined in 0, 30 and 60 min. after injection. Significant suppression of PRL stimulation in the patients was shown as compared with the controls after 30 min and delayed decrease of the curve values was found. An increase in the PRL level after 60 min in investigated group was lower than in control. Lower relative enhance of PRL level in 30 min was found and slower decrease after 60 min. Despite the slower decrease PRL level was lower in the patients than in the controls after 60 min. The highest relative increase in PRL level after 30 min was observed in the patients with lowest initial level of PRL (r=-0.471; p<0.001). Erytropoietin administration improved the response in the test (p=0.005) without relationship to the duration of erytropoietin treatment. There was influence of hemoglobin level on the results of the test.
Results of the MTC test in end-stage renal disease patients is inadequate and the PRL response is diminished. Diagnostic value of the test in end-stage renal disease patients is low. Erytropoietin administration improves although not to the normal values the results of the MTC test.
本研究旨在评估不同高催乳素血症水平的终末期肾病患者接受血液透析时胃复安（MTC）试验值。研究了MTC试验应用的临床价值以及包括促红细胞生成素治疗在内的不同实验室和临床因素的影响。68例年龄在20 - 74岁（平均48±13岁）的血液透析患者（31例男性和37例女性）接受了MTC试验，对照组由8名健康志愿者（4例男性和4例女性）组成。静脉注射10mg MTC，并在注射后0、30和60分钟测定血清催乳素水平。与对照组相比，患者在30分钟后催乳素刺激受到显著抑制，且发现曲线值下降延迟。研究组在60分钟后催乳素水平的升高低于对照组。在30分钟时催乳素水平的相对升高较低，60分钟后下降较慢。尽管下降较慢，但60分钟后患者的催乳素水平仍低于对照组。在初始催乳素水平最低的患者中，观察到30分钟后催乳素水平的相对升高最高（r = -0.471；p < 0.001）。促红细胞生成素的使用改善了试验反应（p = 0.005），且与促红细胞生成素治疗的持续时间无关。血红蛋白水平对试验结果有影响。
终末期肾病患者的MTC试验结果不理想，催乳素反应减弱。该试验在终末期肾病患者中的诊断价值较低。促红细胞生成素的使用改善了MTC试验结果，尽管未达到正常水平。
